Staff training in the mental health needs of people with learning disabilities in the UK

This paper gives a general overview of some of the factors involved in the training and knowledge of learning disabilities staff relating to mental health. Early indications from research have shown that training may be effective as a way of addressing these problems, but further research and clear guidance on best practice in implementing staff training are needed in this important area.

Distress in children with learning disabilities at a respite unit: perspective on their experiences

Numerous studies have investigated the benefits of respite to families with a disabled child. Far fewer have examined the effects on the child and none have systematically compared information about this from different sources. Reports of behavioural reactions and views on distress were gathered from parents, teachers and respite staff. Children were also asked for their views. Over half the children (54%) were reported to show medium or strong negative reactions lasting for 1 or more days by a parent or teacher. Reported reactions varied widely between home and school and no concordance was found between parents, teachers and respite staff groups regarding distress. Some children's views differed from those of their parent or teacher. The findings highlight the extent of differences in perspectives and suggest the need for greater awareness of the possible distress to children attending respite. This is discussed in relation to factors such as the potential conflict of interests between parents and children, communication and behavioural difficulties, and the context in which the child is observed.

Meeting the health needs of people with learning disabilities: guidance for nursing staff

This guide has been produced to support registered nurses and nursing students in primary and secondary care, who are trained in branches other than learning disabilities, to deliver high quality health care to people with learning disabilities.

An evaluation of the implementation of hand held health records with adults with learning disabilities: a cluster randomized controlled trial

Background: Personal health records were implemented with adults with learning disabilities (AWLD) to try to improve their health-care. Materials and Method: Forty GP practices were randomized to the Personal Health Profile (PHP) implementation or control group. Two hundred and one AWLD were interviewed at baseline and 163 followed up after 12 months intervention (PHP group). AWLD and carers of AWLD were employed as research interviewers. AWLD were full research participants. Results: Annual consultation rates in the intervention and control groups at baseline were low (2.3 and 2.6 visits respectively). A slightly greater increase occurred over the year in the intervention group 0.6 ()0.4 to 1.6) visits ⁄ year compared with controls. AWLD in PHP group reported more health problems at follow-up 0.9 (0.0 to 1.8). AWLD liked their PHP (92%) but only 63% AWLD and 55% carers reported PHP usage. Carers had high turnover (34%). Conclusions: No significant outcomes were achieved by the intervention.

The interprofessional practitioner: changing professional identity in social work

Twenty years ago the first joint training programme in learning disability nursing and social work was established as a collaborative project to develop practitioners able to work holistically with people with learning disabilities. Since then a number of programmes have continued this work and more recently the approach has developed in the mental health specialism. These programmes have changed the nature of singular social work education and created a new region of knowledge (Bernstein, 2000) for those who have experienced them. What began as a radical experiment in interprofessional education has been sustained by a strong commitment to the belief that the practitioners who qualify from such programmes are well equipped to support people with learning disabilities in changing and multi-professional services. As with much interprofessional education, however, there is an ongoing need to build an evidence base linking such education with successful outcomes in practice. This paper presents and explores the outcomes of a doctoral research study aimed at evaluating the impact of joint training in learning disability nursing and social work on the professional identity, skills and working practices of practitioners who undertook it. The research was undertaken with almost fifty jointly trained practitioners and involved a national survey followed by semi-structured interviews. The results suggest that practitioners who experience the dual socialisation inherent in this type of training found both gains and losses in the process. They appear to emerge, however, with a confidence, resilience and breadth of knowledge which were part of the early vision for this transformative approach to professional training. Bernstein B. (2000). Pedagogy, Symbolic Control and Identity. Theory, Research, Critique. Revised Edition. Lanham: Rowman and Littlefield (USA).

Creative leadership & communities of practice

This Second Wave presentation focused on 'Creative Leadership and Communities of Practice', with particular reference to issues of trust affecting young people, unemployment and wider uncertainties in an economic recession when people were facing job cuts and in a social environment characterised by cynicism and a downturn in trust. Young people who join Second Wave are brought into a community of practice (CoP) (Lave and Wenger, 1991; Wenger, 1999) involving a dynamic, fluid process which is distinctive in its transformative power to change people's lives. The philosophy behind this involves Dewey's notion of the 'active self' (Dewey, 1916) and the theories of 'social constructivism' (Vygotsky, 1978). The process fosters trust, confidence and social learning (Bandura, 1977; Vygotsky, 1978) in which young people join in with a dialogue involving participation in the youth-centred creative space. The 'border zone' (Heath, 1994) in that creative space enables young people to connect with each other in the specialist field of youth arts. The youth-centred partnerships involved lead to greater confidence and development in a range of important artistic, social, cognitive and emotional skills and opportunities. Ultimately, the young person may become engaged in multi-agency working with Second Wave's external partners. Throughout all of these processes, young people are encouraged progressively to develop a more 'active self' to engage proactively with many different beneficial opportunities relating to the performing arts. In an era in which there has been a loss of trust in public life this is particularly important. If trust is defined in part as a belief in the honesty, competence and benevolence of others, it tends to act like 'social glue', cushioning difficult situations and enabling actions to take place easily that otherwise would not be permissible. The Edelman Trust Barometer for 2009 has recorded a marked diminution of trust in corporations, businesses and government, as a result of the credit crunch. While the US and parts of Europe were showing recovery from a generalised loss of trust by mid-year 2009, the UK had not. Social attitudes in Britain may be hardening - from being a nation of sceptics we may be becoming a nation of cynics: for example, only 13% of the population surveyed by Edelman trust politicians to tell the truth. In this situation, there is a need to promote positive measures to build trust. The presentation aims described key aspects of Second Wave's approach to identify and disseminate its model of good practice to make this more explicit and accessible to others. It is with awareness of the profoundly challenging circumstances facing young people, particularly but not exclusively in inner city urban areas such as Deptford, and the valuable contribution youth arts work can make to their well-being and development, that the presentation was carried out. In an era of generalised mistrust, the work done at Second Wave is crucial in empowering and supporting young people to find a positive and creative direction as part of the community.

Keeping it together: a guide for support staff working with people whose behaviour is challenging

This guide has been written for support staff, working with people with learning disabilities, who are new to challenging behaviour or facing it for the first time. It is a self-help guide and provides practical and realistic information on how direct care staff can develop strageties to support people whose behaviour is challenging and develop their skills in this area.

Routine maintenance and sustainability of existing social housing

Presently the UK social housing stock accounts for approximately 18% of the total UK housing with maintenance costs in the region of £1.25 billion per annum. In terms of its impact on the environment, housing is generally responsible for approximately 27% of the UK’s CO2 emissions. The extent to which routine maintenance (planned preventative and responsive) can be used as a vehicle to improve the overall sustainability (social, environmental and economic) of existing social housing is one focus of a 5 year EPSRC funded research programme. This paper reports on the findings of a series of in-depth interviews with social housing providers examining current social housing maintenance practices and attitudes towards sustainability. This paper will report the initial findings of interviews and outline a new performance based multi-criteria maintenance model from which an AHP hierarchy will be presented, integrating the principles of sustainability into maintenance strategies